A nurse is reinforcing teaching with an assistive personnel (AP) about a client who has pertussis. Which of the following instructions should the nurse include in the teaching?

Choice A reason: Filling the pad with sterile water is not necessary, as tap water can be used for an aquathermia pad without increasing the risk of infection or contamination.

Choice B reason: Using safety pins to secure the pad in place is not appropriate, as they can puncture or damage the pad and cause leakage or electric shock.

Choice C reason: Applying the pad for 45 min at a time is not recommended, as it can cause skin burns or tissue damage due to prolonged exposure to heat. The nurse should apply the pad for no more than 20 min at a time and check the skin frequently for signs of redness or blistering.

Choice D reason: Covering the pad prior to use is an important action, as it can prevent direct contact between the pad and the skin and reduce the risk of burns or irritation. The nurse should use a towel or a cloth to cover the pad before applying it to the affected area.

Choice A: This is incorrect because applying petroleum jelly to the client's nares can interfere with oxygen delivery and cause skin breakdown. The nurse should use water-soluble lubricant or saline spray to moisten the nares and prevent dryness from oxygen therapy.

Choice B: This is correct because initiating fall precautions can prevent injury and complications for the client who has aspirated pneumonia and hypoxia. The client may have altered mental status, weakness, or dizziness due to hypoxia, infection, or medications. The nurse should use bed alarms, side rails, and assistive devices as needed.

Choice C: This is incorrect because maintaining the client in a supine position can worsen hypoxia and pneumonia by decreasing lung expansion and increasing secretions. The nurse should elevate the head of the bed at least 30 degrees and encourage frequent position changes to improve ventilation and drainage.

Choice D: This is incorrect because implementing contact precautions is not indicated for the client who has aspirated pneumonia and hypoxia. Aspirated pneumonia is caused by inhalation of foreign material into the lungs, not by transmission of microorganisms from person to person. The nurse should use standard precautions and droplet precautions if the client has a cough or sputum production.